Utilization Management Reviewer/UKHC

Job Title
Utilization Management Reviewer/UKHC


Requisition Number
RE47921


Working Title
Utilization Management Reviewer


Department Name
H4027: REV Cycle MGT-PFE


Work Location
Lexington, KY


Grade Level
11


Salary Range
$54,080-95,056/year


Type of Position
Staff


Position Time Status
Full-Time


Required Education

ADN



Click here for more information about equivalencies:
https://hr.uky.edu/employment/working-uk/equivalencies


Required Related Experience

5 yrs



Required License/Registration/Certification

Registered Nurse (RN)



Physical Requirements

The physical conditions of this position include: occasionally standing or walking with objects up to 10lbs; regularly sitting at a computer workstation for extended periods of time with repetitive motions (such as typing); regularly working in confined spaces; and occasional exposure to radiation and combative people.



Shift

Day shift Monday through Friday. May work weekends. (Hybrid.)



Job Summary

This position works as a member of the multidisciplinary team with social workers, case managers, financial counselors, and ancillary staff to actively manage and coordinate those functions associated with third party payer certification, appropriate utilization of health services, and some aspects of discharge planning.

This is a hybrid position.



Skills / Knowledge / Abilities

The ideal candidate will possess strong interpersonal, leadership, organizational, and written/verbal communication skills. General knowledge of criteria for accessing appropriate utilization of resources in the hospital is necessary. Exceptional planning and organizational skill. Effective written and verbal communication skills. General knowledge of criteria utilized by third party payers for admission and continued stay authorizations is necessary. General knowledge of Medicare, Medicaid, and third party payer reimbursement issues is necessary.



Does this position have supervisory responsibilities?
No


Preferred Education/Experience

ADN with five years’ direct patient care experience.



Deadline to Apply
11/05/2024


Our University Community

We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors the University of Kentucky is a Tobacco & Drug Free campus.


As an Equal Opportunity Employer, we strongly encourage veterans, individuals with disabilities, women, and all minorities to consider our employment opportunities.


Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.